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首页> 外文学位 >The status of vasectomy in the United States: Economic influences and long-term follow-up in men with no children.
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The status of vasectomy in the United States: Economic influences and long-term follow-up in men with no children.

机译：美国输精管结扎术的现状：对无子女男性的经济影响和长期随访。

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摘要

Background: Vasectomy is surgical occlusion of the vas deferens as a form of male contraception. Vasectomy is the most common non-diagnostic procedure performed by urologists in the United States. While uncommon, a childless man requesting a vasectomy can be an ethically challenging scenario for urologists. We hypothesized that men who had undergone vasectomy prior to having children would have higher rates of vasectomy reversal and family planning attitudes inconsistent with being sterile compared to men undergoing vasectomy after fathering children. We also studied the relationship between national economic conditions and men electing vasectomy.;Methods: We performed an analysis of the 2002, 2006-2010, and 2011-2013 waves of the National Survey for Family Growth (NSFG), a nationally representative survey of family planning in the United States. We compared demographic information and family planning attitudes among men who had undergone vasectomy and compared characteristics of those with vs. without children. We also performed a survival analysis of the National Survey for Family Growth 2002, 2006-2010, and 2011-2013 datasets with additional economic information obtained from the National Bureau of Economic Research and the Bureau of Labor Statistics.;Results: Of the 20,146 men surveyed, 696 (3.5%) reported undergoing a vasectomy. Of the men reporting vasectomy, 3.5% (95% CI 2.4-5.1) underwent the procedure without having had children. Compared to men with children, men without children were older at the time of vasectomy, were less likely to have ever been married, and were more likely to be agnostic or atheist. Whereas 1.3% (0.7-2.5%) of men with children underwent vasectomy reversal during the follow-up, 0% of men without children underwent reversal, p=0.441. When asked how many children they intended to have, men without children expected 0 children, whereas vasectomized men with children expected 0.01 (95% CI: 0.0-0.2), p=0.007.;For the economic analysis, of the 20,146 men who participated in the NSFG, 7,424 men had at least one child, which using NSFG weighting methodology, is equivalent to a national population of 27,329,505 men. Of these men, 12.1 % (95% CI 10.6 -- 13.7) underwent vasectomy after having a child. Using multivariate Cox proportional hazards regression, we found that compared to men in their teens, men ≥ 25 years old were almost twice as likely to undergo vasectomy after having a child [hazard ratio (HR) 1.88 (95% CI 1.29 -- 2.75)]. Compared to men with 1 child, men with two children were 2.61 (95% CI 1.64 -- 4.16) times more likely to undergo vasectomy and men with at least three children were 3.57 (95% CI 2.37 -- 5.37) times more likely have the procedure. Compared to non-Hispanic White men, Black (HR 0.16 95% CI 0.11 -- 0.25), Hispanic (HR 0.23 95% 0.16 -- 0.34), and other minorities (HR 0.35 95% 0.16 -- 0.77) were significantly less likely to undergo vasectomy. Men who had children born during an economic trough were more likely to undergo vasectomy, (HR 1.23 95% 1.01 -- 1.52).;Conclusion: Men who undergo vasectomy without having children constitute a small but distinct population of men. During short term follow-up post vasectomy, men who have not fathered children do not express higher rates of post-vasectomy regret. In addition to demographic factors such as age and race, the economic environment influences a man's likelihood of undergoing vasectomy such that men who have children born during an economic trough are more likely to subsequently undergo a vasectomy.
机译：背景：输精管结扎术是输精管的手术闭塞，是男性避孕的一种形式。输精管结扎术是美国泌尿科医师最常见的非诊断方法。虽然不常见，但要求输精管结扎术的无子女男子可能是泌尿科医师面临的道德挑战。我们假设与生孩子后进行输精管切除术的男人相比，在生子之前进行输精管切除术的男人发生输精管切除术的比率更高，并且计划生育态度与不育相矛盾。我们还研究了国民经济状况与选择输精管结扎术的男性之间的关系。方法：我们对2002年，2006-2010年和2011-2013年全国家庭成长调查（NSFG）进行了分析，这是一项全国代表性的调查。美国的计划生育。我们比较了接受输精管结扎术的男性的人口统计学信息和计划生育态度，并比较了有子女和无子女的男性的特征。我们还对2002年，2006-2010年和2011-2013年全国家庭增长调查数据集进行了生存分析，并从国家经济研究局和劳工统计局获得了更多经济信息。结果：在20146名男性中在接受调查的人中，有696人（3.5％）接受了输精管结扎术。在报告输精管切除术的男性中，有3.5％（95％CI 2.4-5.1）接受了没有孩子的手术。与有孩子的男人相比，没有孩子的男人在输精管结扎术时年龄更大，结婚的可能性较小，并且是不可知论者或无神论者。在随访期间，有1.3％（0.7-2.5％）的有孩子的男性接受了输精管切除术，0％的无孩子的男性接受了输精管切除术，p = 0.441。当被问及打算生育多少个孩子时，没有孩子的男人希望有0个孩子，而被输精管切除术的有孩子的男人希望有0.01个孩子（95％CI：0.0-0.2），p = 0.007。就经济分析而言，参加活动的20146名男人在NSFG中，有7,424名男人至少有一个孩子，使用NSFG加权方法，相当于全国人口27,329,505名。在这些男人中，有12.1％（95％CI 10.6-13.7）在生完孩子后进行了输精管结扎术。使用多变量Cox比例风险回归，我们发现，与25岁以上的男性相比，≥25岁的男性有小孩进行输精管结扎术的几率几乎是男性的[危险比（HR）1.88（95％CI 1.29-2.75） ]。与有一个孩子的男人相比，有两个孩子的男人进行输精管结扎术的可能性高2.61（95％CI 1.64-4.16）倍，有三个以上孩子的男人发生输精管切除术的可能性高3.57（95％CI 2.37-5.37）步骤。与非西班牙裔白人相比，黑人（HR 0.16 95％CI 0.11-0.25），西班牙裔（HR 0.23 95％0.16-0.34）和其他少数民族（HR 0.35 95％0.16-0.77）的可能性明显降低进行输精管结扎术。在经济低谷期间生育孩子的男人更容易进行输精管结扎术（HR 1.23 95％1.01-1.52）;结论：没有孩子而进行输精管结扎术的男人构成了一小部分但截然不同的男人。在输精管切除术后的短期随访中，未生下孩子的男性在输精管切除术后的后悔率并不高。除了年龄和种族等人口统计因素外，经济环境还会影响男人进行输精管结扎术的可能性，因此，在经济低谷期间生育孩子的男人更可能随后接受输精管结扎术。

著录项

  • 作者

    Najari, Bobby B.;

  • 作者单位

    Weill Medical College of Cornell University.;

  • 授予单位 Weill Medical College of Cornell University.;
  • 学科 Health sciences.;Epidemiology.
  • 学位 M.S.
  • 年度 2016
  • 页码 46 p.
  • 总页数 46
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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